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A tension headache is the most common type of headache. It is pain or discomfort in the head, scalp, or neck, and is usually associated with muscle tightness in these areas.
Muscle contraction headache; Headache - benign; Headache - tension; Chronic headaches - tension; Rebound headaches - tension
Tension headaches occur when neck and scalp muscles become tense, or contract. The muscle contractions can be a response to stress, depression, a head injury, and anxiety.
They may occur at any age, but are most common in adults and adolescents.
If a headache occurs two or more times a week for several months or longer, the condition is considered chronic. Chronic daily headaches can result from the under- or over-treatment of a primary headache.
Rebound headaches are headaches that keep coming back. They may occur when pain medicines are overused.
Any activity that causes the head to be held in one position for a long time without moving can cause a headache. Such activities include typing or other computer work, fine work with the hands, and using a microscope. Sleeping in a cold room or sleeping with the neck in an abnormal position may also trigger a tension headache.
Other triggers of tension headaches include:
Tension headaches can occur when you also have a migraine. Tension headaches are not associated with brain diseases.
The headache pain may be described as:
The pain may occur once, constantly, or daily. Pain may last for 30 minutes to 7 days. It may be triggered by or get worse with stress, fatigue, noise, or glare.
There may be difficulty sleeping. Tension headaches usually do not cause nausea or vomiting.
People with tension headaches try to relieve pain by massaging their scalp, temples, or the bottom of the neck.
If your headache is mild to moderate, without other symptoms, and responds to home treatment within a few hours, you may not need further examination or testing.
With a tension headache, there are usually no problems with the nervous system. But tender points (trigger points) in the muscles are often found in the neck and shoulder areas.
The goal is to treat your headache symptoms right away, and to prevent headaches by avoiding or changing your triggers. A key step in doing this involves learning to manage your tension headaches at home by:
Medicines that may relieve a tension headache include:
Be aware that:
If these medicines do not help, talk to your doctor about prescription medicines.
Other treatments that you can discuss with your doctor include relaxation or stress-management training, biofeedback, cognitive behavioral therapy, acupuncture, or botulinum toxin type A (Botox ®).
Tension headaches often respond well to treatment. But if the headaches are chronic, they can interfere with life and work.
Call 911 if:
Also, call your doctor if:
Learn and practice stress management. Some people find relaxation exercises or meditation helpful. Biofeedback may help you improve the effect of doing relaxation exercises, and may be helpful for chronic tension headache.
Tips to prevent tension headaches:
Massaging sore muscles may also help.
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Garza I, Swanson JW, Cheshire WP Jr, et al. Headache and other craniofacial pain. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 69.
Jackson JL, Kuriyama A, Hayashino Y. Botulinum toxin A for prophylactic treatment of migraine and tension headaches in adults: a meta-analysis. JAMA. 2012;307:1736-1745.
Jackson JL, Shimeall W, Sessums L, Dezee KJ, Becher D, Diemer M, et al. Tricyclic antidepressants and headaches: systematic review and meta-analysis. BMJ. 2010. 341:c5222. doi: 10.1136/bmj.c5222.
Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR. Acupuncture for tension-type headache. Cochrane Database Syst Rev. 2009;(1):CD007587.